Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
Scand J Trauma Resusc Emerg Med. 2013 Mar 5;21:16. doi: 10.1186/1757-7241-21-16.
The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital.
Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%).
Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05).
During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses' education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services.
本研究旨在评估坎塔哈梅中央医院急诊科（ED）广泛改革前后护士对自身专业技能的自我报告信心。
2007 年新组织成立前两年，急诊护士开始参加过渡培训。培训后，在新的 ED 进行每周的实践教育课程。在此过程中，护士提高了他们的过渡技能，为新诊所制定了规章制度，并提高了他们对新技术和仪器的了解。使用电子流程图软件描述和模拟涉及重症 ED 患者的主要过程。在过渡培训期间，护士编制了 ED 所需的实用技能和措施清单。根据初级和二级保健医生以及坎塔哈梅中央医院主任医生的反馈意见对这些清单进行了更新。最终的 189 项清单包含 15 个不同类别，每个类别包含 4 到 35 项。基于上述工作，开发了一份问卷，以反映 ED 护士在临床措施方面的技能，同时估计专业教育和实践培训的需求。要求在 ED 工作的护士于 2007 年 1 月（应答率 97%）和 2011 年 1 月（应答率 98%）填写问卷。
在 15 个类别中的 8 个类别中，护士自我报告的专业技能信心显着提高。这些类别包括插管、导尿、患者监测、心脏患者、设备、分诊和护士执业、精神科患者以及感染风险。在导尿、患者监测和感染风险方面取得了最佳效果。在研究 2007 年和 2011 年参加两项调查的护士组时，观察到所有 15 个类别均有改善。除了两个类别外，所有类别的变化均具有统计学意义（p<0.05）。
在急诊服务的广泛改革期间，我们注意到护士的专业技能显着提高。在整个过渡过程中，在 ED 工作的护士中，这种改善尤为一致。基于致力于急诊服务的护士和医生之间的合作，在 ED 中实施护士教育和培训计划可能会取得成功。
